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Less than thorough fellow hygienist!

I worked with two other hygienists. We often see each other’s patients. I know there’s an unspoken code to not talk ‘down’ a fellow hygienist. I consistently see recharge patients with residual calculus, pt question why I am so ‘rough’ as they’ve never had their teeth cleaned like that before. The hygienist takes 20-30 for every adult prophy. Some patients are appreciative for the thorough cleaning. My dilemma is, do I talk to the other hygienist and if so, what do I say?

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12 Answers

As an oral care provider I have seen some interesting things: 1) I did srp on a pt’s right side and took after pictures to show her. I kid you not in 3 weeks she showed up with heavy supra ginival again on that right side. I was scheduled to srp the left and was so pissed. I review OH AGAIN and performed maintenance on the right as well as srp on the left that day.
2) Sometimes we scale and scale and scale and at the follow up you may find a piece of residual. At that time you remove it and re-evaluate the pocket. Subgingival is all tactile.
3) Unless you see the patient immediately after the hygienist we cannot always assume the other hygienist did not remove it. I have patients with evident radiographic calculus that I performed SRP and within a year of that they have radiographic again even though they come in for maintenance. IN my practice I am allowed to take a post op X-ray on patients I want to double check for calculus s well as explore of course so I’m sure I know I did a good job, but patients can lie and be non compliant
4) If all else fails and you think its definitely not a through job I personally would not confront the other hygienist because that would cause friction in your work place forever!

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I think in this case it is about how you approach the hygienist about it. When I first started out after graduation I had another hygienist with 10 years experience come to me on a lunch break with no one else around and said “Look I saw this patient today that you did SRP on and I think I have a few tips that might help you in some difficult to scale areas”. She approached it from a mentoring view point and I was so glad she did. I wasn’t upset and I didn’t resent her or make it a hostile work environment. I learned from her and it only made me better and benefited my future patients. To leave it alone knowing in the end its the patient’s health that suffers doesn’t feel right to me. We all need help from time to time to get better at the skills we may be a little weak in. How are we to improve if we don’t know we need to? Hygienists need to stick together and have each other’s backs. Trying to help her as long as it is done in a tactful and respectful way will benefit everyone.

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That is a tough one. I would probably show patients the calculus you are removing. Use floss or an explorer to let them “feel” the click. Tell them it is necessary to remove the calculus to control perio disease. No need to tell them that it is residual…patients are smart and over time will appreciate your thoroughness. For the ones that don’t, they will request the hygienist that just buffs and polishes. Confronting the other hygienist might cause animosity.
I would just take pride in your work and know you are doing what is best.

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Honestly most offices have a 20 min hygienist….Dont for a second think both the Dr’s and the patients dont recognize the difference….I never get the “being rough” comments..only the “wow, I havent had a cleaning like that before!”..when I ask if that means I was rough they say “ohhh no thank you it was very thorough”..if some are ok with the short clean you cant regulate it…far more appreciate full time invested…I now even have Dr’s refer difficult atients directly to me spcifically…that use to irritate me but I have come to accept it as a compliment and it values me in the practice….Just do you, the rest becomes evident and nothing needs to be said…after a while the Dr may start requesting things be done more like you do them…Granted I am now only part time, its harder to let it all roll off when full time is invested….just focus on the benefit they are getting by seeing you….every office I’ve ever worked in experiences this to some degree…sad but true…

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This question actually just made me re-evaluate myself because I find that I’m very fast @ what I do. Sometimes it worries me that the other hygienists will think I’m not thorough or doing my job correctly.
Honestly after thinking about it though I know I’m still just as thorough, & pretty much I’m an over preparer, as well as I’m always thinking way ahead and kind of figured out the best way to move through all the things I do in one apt order I approach things. My patients compliment me a lot, a lot tell me wow your very thorough, or my teeth never feel this clean when I see someone else and they don’t complain about me being rough when I ask. I do agree that you shouldn’t assume she isn’t doing a good job some form it quickly, if these patients are telling you though that you were more thorough or telling you that you made their teeth feel cleaner than she did previously then clearly she isn’t very thorough. I would approach the situation with care & great caution but it does need addressed and it’s better it’s a fellow hygienist than someone else like the dentist. It seems less threatening to have someone else approach you about a situation that it’s in the same position as you then someone who is not because this way they don’t feel like they are being bossed around or told they are doing something wrong from someone who doesn’t know really know what her job consists of day after day

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I think everyone deals with this situation. However, we all do not remove 100% of sub g calculus 100% of the time. I would just do your job to the best of your ability and let the situation play out instead of causing tension between coworkers.

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I don’t think I would ask her if she’s leaving calculus but maybe you can approach her where you are asking for her opinion. When you clean one of her previous patients you could ask her if she’s ever noticed that particular patient getting calculus faster than most patients and if the patient seemed willing to floss and interested in home care instructions. Then you could ask her opinion on treating the patient. This way you have brought the calculus to her attention but she won’t feel you are attacking her. If she isn’t being thorough hopefully you brining the calculus up will make her start being thorough.

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Me personally as getting ready to enter the field would love the feed back of another hygienist. We all have aspects to improve on and I feel that working in an office together is a team. We should work together to provide the best service possible. I think you should approach them in a way that would not upset them up inspire them to do better.

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I agree with Avalene. Some patients build calculus up so fast and within two months the whole lingual sides of the mandiular arch was covered almost to the incisal edges. I’m glad I took before and after same day and before and after at that two month mark.
I also have seen missed calculus on new patients. I’ve missed little black specks due to the heavy hemo, but removed it at next appt. it’s a tough call. I think…..if it continues you should ask her opinion on certain patients and show her the residual calc on radiographs and ask her how she would handle it……maybe then she will know she needs to start being more thorough or she will be called up again.

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This happens in our office too! We have three hygienists and two of us agree that the other hyg. Does not always get all of the calc and sometimes we can see it when we take X-rays at the next visit. We tried to discuss this with her but it did not go well 🙁 we have informed the office manager and she is now dealing with it.

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I feel like it depends on the other RDH’s , are they newer, and need remediation or more time? or ore they more experienced? If it’s the former, show her on the x ray, just pull it up and ask her do you see any calculus on this? reply accordingly, if she is more experienced, as it was in my case when this happened to me, just let it go, and keep doing your best…it rarely ends well….

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I work with another hygienist, we have worked together for 18 years. I trust her and there is a strong communication between us. Sometimes we get comfortable in a patient we have seen for years and “maintaining” that patients disease. Then that patient gets into the other schedule and they are being scheduled for SRP. Is it something we miss or are we just comfortable in continuing care? Fresh eyes only benefits our existing patients and I am grateful every day for that.

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